The global burden of non-communicable diseases (NCDs) is one of the biggest threats to international health and development, confirms a major new Series in the Lancet today. These diseases – cancer, cardiovascular disease, and chronic respiratory disease and diabetes – are the most common cause of death and disability, accounting for 54% of all disability and 65% of deaths worldwide. Rising fastest in low- and middle-income countries and impacting disproportionately on disadvantaged communities; NCDs are threatening human and economic development.
Produced by some of the world's most eminent scientists and academics, including from within the NCD Alliance civil society network, the Series provides the evidence for NCDs as a development issue and proposes cost-effective interventions to accelerate progress and avert millions of deaths worldwide. The Series highlights the urgent need to include NCDs in the post-2015 development agenda and the new development goals being devised over the next 2 years by governments and the United Nations (UN).
Since its inception in 2009, the NCD Alliance has been calling for the inclusion of NCDs in the global development agenda. Mary Gospodarowicz, President of the Union for International Cancer Control, who participated in the launch of the Lancet Series said "the omission of NCDs from the Millennium Development Goals has cost us years of action and millions of lives. The post-2015 development agenda provides a unique opportunity to put this right and ensure that NCD prevention and control is central to the future development agenda."
The Series builds on the clear political mandate for the inclusion of NCDs in post-2015. Governments recognised NCDs as one of the greatest challenges to development in the 21st century at the UN High-Level Summit on NCDs in 2011. Sir Michael Hirst, President of the International Diabetes Federation said "the NCD community must now take strong actions to ensure the evidence and this political recognition is translated into the meaningful inclusion of NCDs in the post-2015 development agenda. It will catalyse leadership and resources, and drive improvements in availability of life-saving medicines and technologies for people at risk or living with NCDs".
The new Lancet Series provides new evidence for country-level action on NCDs, including on access to essential medicines and reducing inequalities in the disease response, and proposes concrete recommendations to governments as they implement commitments on NCD prevention and control. As Dr K. Srinath Reddy, President of World Heart Federation, observed, "The Lancet series provides further evidence to ensure that the ambitious target of a 25 per cent reduction in premature NCD mortality by 2025 can be best achieved, by integrating NCDs into new development goals."
The authors present a compelling case for including NCDs in the future development agenda. Dr E. Jane Carter, President of the International Union Against Tuberculosis and Lung Disease (The Union), stated: "The NCDA Alliance congratulates The Lancet on the timely publication of this Series, which provides vital evidence and arguments as to why NCDs cannot and must not be ignored in the post-2015 international development process, as well as solutions that show the way forward. We encourage you all to use this publication for your local-level advocacy efforts and continue in our united fight to avoid the millions of needless deaths that occur each year".
The 4th Lancet NCD series includes:
Series 1 – NCDs must play a central role in world's next development goals
Alleyne G, Binagwaho A, Haines A, Jahan S, Nugent R, Rojhani A, Stuckler D, on behalf of the Lancet NCD Action Group. Embedding non-communicable diseases in the post-2015 development agenda.
The case for making NCDs central to the post-2015 development agenda and the new development goals being devised over the next 2 years by governments and the United Nations is outlined.
Series 2 – Implementing three cost-effective interventions could rapidly reduce NCD death and disability rates in all countries
Bonita R, Magnusson R, Bovet P, Zhao D, Malta DC, Geneau R, Suh I, Thankappan KR, McKee M, Hospedales J, de Courten M, Capewell S, Beaglehole R, on behalf of the Lancet NCD Action Group. Country actions to meet non-communicable diseases: a stepwise approach.
Researchers outline how to implement measures to control tobacco use, reduce levels of salt intake (to reduce blood pressure) across the whole population, and provide appropriate drug treatment for all people who have had a heart attack or stroke or who are at high risk of one. These interventions could cost governments in the poorest nations as little as US$1.00–$2.00 per head and significantly reduce deaths and disability from NCDs in all countries.
Series 3 – Addressing social and economic inequalities among disadvantaged groups vital to tackling NCDs
Di Cesare M, Khang Y-H, Asaria P, Blakely T, Cowan MJ, Farzadfar F, Guerrero R, Ikeda N, Kyobutungi C, Msyamboza KP, Oum S, Lynch JW, Marmot MG, Ezzati M, on behalf of the Lancet NCD Action Group. Inequalities in noncommunicable diseases and effective responses.
The paper shows efforts to tackle NCDs will only succeed with a focus on both the health of the most disadvantaged people within societies, who disproportionately contribute to the overall burden of NCDs, and the poorest nations where deaths from NCDs and many NCD risk factors are highest.
Series 4 – Multinational food, drink, and alcohol industries are using similar strategies to tobacco industry to undermine public health policies and should be regulated
Moodie R, Stuckler D, Monteiro C, Sheron N, Neal B, Thamarangsi T, Lincoln P, Caswell S, on behalf of the Lancet NCD Action Group. Profits and Pandemics; preventing the harmful influence of the tobacco, alcohol and ultra-processed food and drink industries.
An international analysis of food, drink, and alcohol industry involvement in NCD policies shows that despite the common reliance on industry self-regulation and public-private partnerships to improve public health, there is no evidence to support either their effectiveness or safety.
Series 5 – Most NCDs could be treated with small number of cheap generic drugs and within existing budgets
Hogerzeil HV, Liberman J, Wirtz VJ, Kishore SP, Selvaraj S, Kiddell-Monroe R, Mwangi-Powell FN,
von Schoen-Angerer T, on behalf of the Lancet NCD Action Group. Promoting access to essential medicines for non-communicable diseases: practical implications of the UN Political Declaration.
Researchers say that most NCDs could be treated with a small range of inexpensive, off-patent medicines, and suggest that substantial improvements in availability of life-saving drugs in poorer nations could be achieved within existing budgets by more careful selection and sourcing of generic versions, and better targeting of people at highest risk.
Click here to access the Series and in addition to read the Viewpoint and 3 Comments
About the NCD Alliance
The NCD Alliance (NCDA) is a network of over 2,000 civil society organisations from 170 countries united by our vision for a future free from preventable suffering and death caused NCDs. Our founders are four leading international federations- the Union for International Cancer Control, International Diabetes Federation, the International Union Against Tuberculosis and Lung Disease, and the World Heart Federation. More information can be found on our website: www.ncdalliance.org